Frontiers in immunology · 2026
Flat dose intravenous immunoglobulin primary infection prophylaxis in multiple myeloma patients on BCMA and GPRC5D bispecific antibody therapy: the Vanderbilt experience.
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Marneni Naimisha, Lessans Spencer, Dholaria Bhagirathbhai, Sengsayadeth Salyka, Biltibo Eden A, Patel Vivek, Bhaskar Shakthi, Jayani Reena, Mohan Sanjay, Kishtagari Ashwin, Morgan David, Oluwole Olalekan O, Savani Bipin N, Kassim Adetola A, Baljevic Muhamed
Аннотация
Bispecific antibodies (BsAbs) can cause profound hypogammaglobulinemia. Conventional infection prophylaxis has utilized weight-based IVIG dosing. However, the use of flat IVIG dosing can significantly reduce IVIG utilization. We evaluated hypogammaglobulinemia and infection risk in relapsed/refractory multiple myeloma (RRMM) patients treated with BsAbs who received flat-dose IVIG for primary infection prophylaxis. Among thirty patients, 73% had ≥1 and 43% had ≥2 infectious episodes. By severity, 27% of infections were CTCAE v5 grade three or higher and there were 2 sepsis-related deaths. Overall, flat-dose IVIG demonstrates feasibility for primary infection prophylaxis in RRMM patients receiving BsAbs.